CoPays – When 95% savings is just not enough

Probably the most confusing and frustrating concept in the pharmacy world.

The idea is simple. You pay the pharmacy money to help pay for your drug, hence the word Co-Pay. Like Cooperative Pay, you and your insurance company are joining forces to pay the pharmacy for the goods given to you. If it were that simple then I wouldn’t have a website.

When I hear that I’m needed out front because a patient has a question about a copay, my GERD goes through the roof. Not because the concept is hard, but I know that I’m going to get yelled at and blamed for something that is 100% not my responsibility, not my fault, and to be honest a whole truckload of not my fucking problem. I’m a pharmacist, I make sure drugs don’t kill you, I don’t give a fuck about an issue between you and your insurance company. Your insurance company says I need to collect $x, so the bill is $x.

The most frustrating (and that requires the most restraint on my part) is when people bitch that their copays got bumped up from $5 to like $15 for shit like Aciphex, Nexium, or some other drug that costs over $100. I really have a hard time not taking their prescription back, running it out as cash, and saying “here ya go, pay that now you ungrateful stupid fuck”. These people are stupid, and really dont get the concept that they are getting $150+ worth of medication for $15. “I pay premiums I want my insurance to pay for all of it!” says the idiot who is getting about $500 worth of medication totaling $50 worth of copays with $200/month premiums. You are getting MORE OUT than you are PUTTING IN and BITCHING ABOUT IT!!!! No wonder why this system is all broken.

Idiots on socialized plans (Medicare/Medicaid) are even worse, because their copays are like $3.10 which is MORE of a slap in the face when they bitch/cant pony the cash for their $200 worth of shit they probably don’t need.

Enbrel, $3.10 copay, cue the massive whining and bitching on how someone is on a “fixed income” and cant pay. Enbrel is thousands of dollars for $3.10. Three fucking ten. You cant even buy a fucking value meal at McDonalds for $3.10!!! This fucking twat is whining at me for having to pay!! I’m sorry honey, but that $3.10 is my whole profit from this Rx, so I’m not letting you pay me on the first. Personal finance 101, make sure you have $3.10 for your Enbrel – Thank you.

I mean really, if you went to go and buy a TV at Best Buy that costs $400, and you threw a fit because you had to pay out of your own pocket $25 for this $400 TV, would you be upset if people called you stupid? Would you be upset if the salesman said “Listen you fucking idiot, the rest of the world has to pay a whole fuckload more than you, and you’re whining about a measly $25 for a $400 product?!?”

Then there is this bullshit rumor that we set the copays. If pharmacists could set insurance copays, then maybe the bitching and whining would have some merit. However the HUGE FUCKING NON-SECRET is that PHARMACISTS DO NOT SET YOUR COPAYS (unless you are paying cash). They are transmitted to us via computer and are set by the insurance company that YOU PAY (or we pay) TO PROVIDE YOU Rx COVERAGE. Does the Taco Bell drive up teller set the price of your burrito? NO! They punch a burrito into the computer and it spits out how much you need to pay. Pharmacy is the exact same fucking thing, but people still don’t get it.

People want something or someone to bitch at because of their copays. Yeah, that’s fine, but bitch at some Indian drone at Blue Cross, not me.

For some of us “stupid fucks” the difference between $5 and $15 could be the difference between eating one day or not. Not all of us are lucky enough to have jobs that pay enough. I have been laid off for 3 months and haven’t been able to find work in that time. I have 3 prescriptions monthly, the total payment for copays is $30 ($10 each). To you, a pharmacist who is obviously making a decent living, this may be pocket change, but for me it is an amount I can’t pay. I have to chose which is worse, going without my medications or going without food. So before you judge the “ungrateful stupid fuck”, you may want to consider why/where their frustrations are coming from.

Regarding the people “getting more out” than they are “putting in”: I mean, isn’t that the whole point of insurance in the first place? Some people are really sick and have super high medical costs and others don’t, so the idea is that when people are healthy they put more into the system than they take out. When they are sick they take more out than they put in. Otherwise, we wouldn’t even have insurance. But really, you should explain the concept of the co-pay to them in terms they understand: A co-pay is a way for your insurer to encourage you not to get drugs you don’t really need. A co-pay often doesn’t make a dent in the total price of the drug.

Its all about something for nothing. Whats even worse that this? When you have to appologize for NOTHING!!! Just because someone doesnt get their way they can complain to a store manager…whine whine…whahhhhhhhh….and then you have to call them an appologize when you have done nothing wrong. NO Means NO….and the sooner corporate bosses would allow such things to stand better off we would be. Had 1 person who bought her rx. She had NO question about anything. Comes back the next day wanting to return in. I said once it leaves the pharmacy, I cant take it back. She goes on and on…but I wished I could say is…look here B*tch, you bought the rx and didnt question anything. I cant help if you got buyers remorse now.

Im not going to take back anything that has been in someone’s home. I even asked her ” so you would have no problem if I dispensed something to you that was in a strangers home?” She had the gaul to say ” it would depend”. I shook my head, no. I dont buy it. Then she asked if I would give her a credit? Credit for what? WTF!! You bought it….its yours.

if you dont like the co-pays or price…then before your doctor writes out a script…tell him you want something cheap!!! And tell him your price range for cheap. But dont B*tch at me if you pay for something and accept your copay only wanting to bring it back.

love your blog, it is so F**king truth on everything, we are not a f**king people that other can lash out on, we try to f**king help not to kill the damn ass. they need to appreciate it, I always tell those f**king ass if you want the drugs, I have no problems for them to die in front of me. I will not attend their funeral period.

Some of us don’t have a choice. I have ulcerative colitis, literally tried everything we could before going on humira which without insurance is about $4,000 a month. My copay is $1,000, I have a savings card for the medication but the account is going to run out of money at some point which means I will have to pay more for the medication than I can afford.

Very true. But I have yet to find a pharmasits, or any type of health providor that mentions the true cost of the drug/procedure. When you dispence it shoud go something like this.
“That will be $115.00, and your insurance is paying 100, Your total is $15”
Instead its always, “Here ya go, that will be $15”
YOU need to educate your customer, since only you know the actual price.

How about the consumer educate themselves about THEIR insurance? I know what my copays are supposed to be for brand name and generic because I read the info I received when I signed up for the plan. That is the consumer’s responsibility, not the pharmacists. Get real.

yes, to an extent you are right, but unfortanately, there are LOTS of people who do not truly understand the running of insurances and co-pays vs co-insurance, etc. so when working in a job where your customers are your “patients”, it is also the responsiblity of the pharmacists to explain…therefore, hopefully educating that person so they will have a better comprehension in the future. that’s the only way it will work, is by educating people.

if you dont like to explain, then get out of customer service career fields.

BRAVO!!! I didn’t sign them up for their insurance. I’m not even allowed to provide an opinion on what insurance i think is “best”. If the average patient would take the time to look at a plan, their formulary, and their own med list, it would save them a lot of headaches. The amount of our headaches saved, well, i don’t think they invented a number that high yet.

Great advice, Dear Abby. I HAVE made many attempts in my career at the retail level to explain to patients the total cost of the drug vs the copay charged to the patient by their insurance, even pointing out the cash cost on their receipt upon pickup. People STILL don’t get it. Blaming the pharmacists is force of habit for many, I understand, regardless of the issue. No, you may not have fries with that.

Larry
Why would the provider be responsible for educating YOU about the insurance YOU purchased? YOU bought the insurance, it is YOUR responsibility to know the coverage. A provider could give the price as if you did not have any coverage but the contract to pay for your service is between the provider and the insurance. If you know the full cost of a medication or procedure would you refuse take it?

I personally don’t think it is the pharmacist or techs responsibility to educate the patient on the cost of their copay. In my pharmacy, we told people the cash cost when they inquired. In my experience, and since this post was largely about copays, very few people take the time to read or ask questions of their insurance provider, as to what is covered/not covered and what the premiums might be. There is a toll free number on the back or bottom of most insurance cards. It is there for a reason. Select companies now even offer a list of drugs covered online. Very seldom do people use this information. Instead, they rely on the people behind the counter to provide it. They wait until they get up to the pharmacy to begin asking questions. Do you realize there are thousands of different plans? All with different variables? All that will ultimately affect the copayment amount? I’ve never understood how people can select a plan and not be educated about their own choices. We can not access your personal insurance information any more than we could access your bank account. We can call on your behalf and make an inqury as to why something isn’t covered (non-formulary, etc) but it was something you could have found out long before you arrived in front of us. It makes me wonder how people purchase cars or homes or anything of value and consequence by themselves?

People do not hold themselves accountable for anything anymore. Everything is someone elses problem. And if something ends in disarray, it isn’t because they made an error in judgement, or admit that they haven’t the slights clue how the system works, it is becasue someone else did them wrong. People expect others to take care of everything for them, including the acceptance of blame when it goes wrong. This is why people don’t look at their insurance policies. They feel it is someone elses “job” (our job) to take care of it – Even though we do this at no cost. As far as “how do people purchase cars or homes or anything of value and consequence by themselves?” — they do it the same way they deal with their insurance — they let someone else deal with it. They let the carsales person and banker tell them what is good for them. Any reasonable person knows this is a poor personal policy — letting the people with the most to gain tell you what you can and cannot afford. We all saw how that turned out. People bought mortgages on terms they had no right even looking at and now they turned in their old, paid off, cars for new ones with long term loan payments (cash for clunkers). People need to wisen up.

did you ever hear of asking a pharmacist for a price check yep that is right giant eagle has been giving me my drugs at a discount card of theirs but failed to mention that if they do a price check it is 5.00 less…there has been times I didnt’ have the xtra dollars and couldn’t get my meds….I am having them go back since 2006 when I first began there and getting my fucking refund of MY MY yes MY monies…what ya think about that one!
Brenda

That would mean the superior SOB would have to articulate and treat the consumer with some kind of respect and that would too hard on the foul mouth illiterate thug.
As far as any of these socially presumptuous vile pigs being at a funeral,who wants their nasty ugly mug their anyway! So what!!!!
By the way Jen we consumer educate ourselves all the time and then we’re treated like know-it-alls who think we know something, but then when we have a question or concern we’re told by scum like you to educate ourselves.
I wish I knew what pharmacies these were,because I would post their names everywhere, but of course these social grubs can run their mouth,but they can’t show their face,they don’t deserve customers. They deserve the food line. So they can learn courtesy and empathy. The rest of us have nothing on these people when it comes to entitlement issues. The passive aggressive greedy bags want our money, but resent having to exhibit curtsey and respect.
People pay about $450 a month for insurance and many folks pay more then that! So which ever one you bozos said “something for nothing ” can shove it right up your nose and out your ear. The prices on pharmaceutical can not be justified! What we have here is gouging and gaslighting nothing more!

Well TAP this is right up there with me having a person on state aid driving a brand new car and complaining about there 3 dollar copay, or the person in the hummer complaining about not having 3 dollars to pay there copay.

its these people that make me want to report them to the state for fraud and see where it goes from there.

Day after day after day do people come by (usually drive-thru) to pick up their meds, and many times do not have any money on them and expect to drive off with their Rx, yet there’s a copay… “It’s not covered? Why isn’t Medicaid/Medicare paying for it?”
“They DID cover it, and that will be $1.00”
“I’m gonna have to come back”
And off they go in their SUV/brand new 4-door Dodge Ram truck/new car….

I’m pretty sure every single one of us who works in pharmacy business can go on and on about people and their misuse of state aid.

I love it when you tell them that the reason their copay went up is because they are in the donut hole, they don’t believe you and make you call the insurance company (which, by the way, they want you to do when there are eScribes up the wazoo in the queue and 15 people waiting, and there is only 2 techs and 1 pharmacist), which the insurance company tells you “SURPRISE!! They are in the donut hole!!”

I’m with you 100%. I’m not in the pharmacy (or medical) biz, but I have enough brains to figure out that $15 bucks for a prescription is better than $365……I don’t know how you do it. I would have killed someone a long time ago if I was in your line of business.

Just a shout out to my pharmacist Scott and his team. Why? Because he’s wonderful and so is his staff. I get Humira and other expensive drugs and am almost embarassed about how low my copay is. After all the kindness they’ve shown me on days when I was at my worst can never be repaid, I sure hope I”ve never bitched about a copay and if I did I’m sorry.

Just know, and I’m sure you do, that a good pharmacist and team makes a world of difference for people that have multiple, chronic illnesses from a totally rouge immune system. Because we love you.

I’ve been lurking for months, and always find your site informative. That’s why I passed it on to my “team”.

Every time I have some one bitch to me about a copay, I look up the cash price and tell them it. Usually most will shut up when they see that their $20 or $30 copay isn’t so bad when when the cash price is about $500 or more. On the other hand I’ve also had a customer come off medicaid and bitch to me how it was to expensive to pay like $4 for a bunch of prescriptions worth $300, then the stupid idiot is tries to play the game of “I don’t have private insurance, I have medicaid. Bill through them and wave the copays”, when medicaid rejected the claim, the customer had a hissy fit and demanded the scripts back and said the competator down the street would bill medicaid for her, even though we knew from the rejection that the medicaid was no longer active.

@ Larry, true the pharmacist can vocalize you the cash price prior to ringing you out, but you too can look at the sale slip which usually has the cash price list as well as your co-pay. I would put my life on it that even if you tell the patient how much it cost and then how much the co-pay is, they’ll still call you later bitching about.

Or, try explaining something is Non-Formulary or requires a Prior Auth. Ppl think that just because the doc wrote a prescription it should be covered and at their normal copays. I agree with Larry, I tell them they can pay out of pocket if they’d rather and give them the cash price. I hate getting yelled at or blamed for insurance issues!

My copays are $10, $20 & $40. Most of my scripts fall in the $20 range, but 2 of them are in the $40. I smile and say “Thank you, have a good day!” as the person at the pharmacy hands me the meds that I’m not paying over a thousand dollars for. Yes, I have enough medical problems that too many copays start to add up…it’s called doing without other unnecessary shit, using coupons/sales, and learning to be more creative with what you do have! And I know pharmacy people hate these, but I go to the websites for all my meds on a regular basis & look for coupons/savings cards.

For the genius who said only the “pharmasits” knows the actual cost of the medicine-not remotely true. Picked up 2 prescriptions last night b/c I have pneumonia & the flu, and printed right on my pharmacy receipts: Tamiflu, Retail price: 109.99, Your insurance saved you: 89.99, Your price: 20.00 Ciprofloxacin, Retail price: 29.79, Your insurance saved you: 22.39, Your price: 7.40 You can also go to many pharmacy websites to find out a drug’s actual cost.

Prices printing on the Rx receipts varies from store to store, and is just a feature in a Pharmacy system. Not all pharmacies share the same software, therefore things/features will be different. At my pharmacy, usually just the co-pay is shown, but sometimes (and I have not yet figured out when and why) the cash amount is printed above the co-pay. However it is possible to ask us the cash price and in seconds we can let the patient know.

It gets weirder. Went to pick up a script for my kid last night. They gave me the brand because the generic is actually a HIGHER copay for this particular drug. They even showed the print-out to me to prove it.

That’s because the PBM is getting a rebate from the manufacturer. It costs the insurance plan more, but the PBM makes more money so they have a formulary and copay structure that encorages the use of products with the best rebates.

I don’t typically get mad at my pharmacy cause none of it is their issue although I admit to being surprised when my daughter’s co-pay when from 10 to 20 bucks. I think the issue for me is not the cost change but the lack of notification of that change to me.

That being said, do you know the average cost of Diuril is? I don’t think for whatever reason that my daughter’s insurance is covering it.

The pharmacy has no idea what YOUR co-pay is going to be until the pharmacy bills YOUR insurance company. The pharmacy has a contract with the insurance company which say it will be paid a total of X dollars for prescription Y. “X” includes co-pay and insurance payment. So, if the contracted rate for a certain Rx is $25, and YOUR co-pay is $10, YOUR insurance company will pay the pharmacy $15. YOUR co-pay is the amount that YOU agreed to pay toward YOUR prescription when YOU signed the contract with YOUR insurance company. Rather than get upset at the pharmacy, I would call YOUR insurance company and raise hell with them for changing the terms of YOUR contract without notification.

Whereas i do usually feel bad when a patient’s copay goes up, and i wish i had the time to research these increases, if I actually took the time to do so, nobody would get their meds. It all goes back to a patient being up to date on THEIR insurance, because i certainly wouldn’t ask them why my car premium went up.

First of all patients are not customers. Second of all the insurance companies need to educate their members about their plan design. I didnt spend $100,000 on my education to explain a cost issue. Thank you.

Today this lady told me that she was going on vacation far away so she wanted to make sure she had all her meds.When it came time to pay her co-pay though she’s broke. She told me her social security check barely pays for her to feed her dog. I wanted to yell you are going on VACATION! but you can’t afford your $3.00 copay! WTF!

And, while I may feel bad for someone in that type of situation, it is not my problem. I don’t own these drugs, the company I work for owns them. Therefore, before I can give them to you, you have to pay for them. Whether you are flat broke or not. Period.

Lady comes in to pick up some scrips (on medicaid). Dr. called in 3 scrips, 1 was OTC and medicaid didn’t cover it. I went out to the front store to pick the cheapest generic of this OTC, and it came out to be ~$4 total that she had to pay. She of course argued about this even after we explained why medicaid wouldn’t cover it and that it was only $4 she’d have to pay. she left without getting the OTC and came back a couple of hours later. I’m ringing up this generic OTC which is still $4, i tell her its the generic and she stops me and goes and gets the brand, saying she’d prefer the brand for this. and pays $2 more for it.

Guy comes in my store today and gets 2 scrips 0 co-pay on both. i tell him he owes nothing, ring him up and give him his receipt. he asks for the cash price of one of the scripts, i tell him its #45. then he decides he wants to refund that prescription a(0 copay) nd get an OTC equivalent because he didn’t want the $45 going towards his deductible.

The only time I’ve ever bitched about a copay was when my insurer asked for a $150 copay on a monthly maintenance med I can’t go without, because they wanted me to switch to a cheaper alternative that, while it was in the same class of drugs, was not remotely the same chemical. Yes, it would have cost me $300 if they paid nothing. But I can’t pay $150 a month for a med any more than I can pay $150.

I don’t get complaining about any copay under $25, though. And my only complaint to the actual pharmacy staff (an aide) was “Crap, couldn’t you have told me it was going to be so expensive when I called and asked if I was covered for it? I would have told you not to dispense it…”

I don’t argue with your points..but being one of those pharmacy staff, I usually tell the person the price when they call..save the trouble. But if you call me and ask “is my insurance covering it” and I say “Yes” that’s not requesting the price…that’s simply asking if it’s covered or not. Just because your insurance sees it as a high formulary doesn’t mean that it’s not covered. I’ve watched and dispensed Singulair to patients that have a $15 copay whereas I have to pay $45 a month for it…doesn’t mean i’m not covered, just means I have a differant insurance with a different formulary.

But like I said, I don’t disagree with your points…I always tell the patients that I check out that if they have a question about the price, the copay, or the medication that I have no problem double checking things and explaining things if need be. Sometimes we don’t even get an explanation…it’s like TAP said, we submit a claim and they send us a price with no explanation. It’s not really our job to call them and have them tell us they’d prefer you to switch and THAT’S why it’s so much…it’s yours.

Hey larry, I don’t know about rite aid or wally world but at good ole giant eagle we print both the cash price and your copay right on the bill. On average at least 10 people a week will complain to me that their medication’s cash price is to high therefore making their copay go up and somehow again my fault. Also truly annoying, half of my phone calls involving the question ” can u tell me how much my script is so I know if I have enough money?” are from people who pay either 1$ or nothing for their script. REALLY? ARE YOU KIDDING ME? you know dam well your script is always a dam dollar or its free, STOP calling me!!! If it is more then a dollar it is because you missed your last appointment with your welfare caseworker and therefore have been cut off…and you already knew that didn’t you

this is so true: The “most of the people who call are those who have $1.10 co-pays.” I’d say probably 80% of callers asking for the price are those patients. If they know they’ve just recently had 3 scripts filled, and their co-pays are always $1.10 or $3.30, then make sure you have $10! That’s it and no more! and it will be a nice “surprise” to find that every one was just 1.10, then you only have to pay $3!

Hey Larry? Does your doctor educate you about the true costs of what they provide and walk you through the paying process? Our job as pharmacists is to dispense the right drug, for the right condition, to the right patient. How about you ask for that after hours class from your Human Resources people, or better yet, the insurance company? Oh yeah, WE’RE the only ones open when HR and BCBS goes home. Read the freakin’ policy.

To respond to Larry, I was told by management (so this may or may not be true!) that we were not allowed to tell the customer how much their insurance paid towards the medication; ie, insurance paid $100, now you pay me another $15. It used to say how much the insurance pain on the label we gave to the patient, and then they took it off, and when patients complained, they said that this is in violation of the contract that my company makes with each insurance company. So, we were told that if patients asked how much their insurance paid on the claim, they had to be told to call the insurance company. You can imagine how well that excuse goes over….

So like I said, I have no way of knowing if that is true or not, but that is the line I have been told to tow by my company.

Co-pay complaints do drive me nuts, but I think it’s hard b/c the average person has no idea how much drugs cost – and why should they? I have no idea how much it costs my mechanic to stock his shelves….although in our case, the situation is reversed. My mechanic pays $X for the oil, and charges me $X + $20, whereas oftentimes I pay $X for a drug and then get told by the insurance company I am only getting $X – $20.

I have repeatedly shown my customers how to read their receipts and see for themselves how much their insurance took off, and remind them how lucky they are because at my last job, I had “insurance” that made us pay the whole cash price up front, mail it in, and only get reimbursed for half two months later. It usually shuts them right up.
On the other hand…this week I had one guy who wanted to sign up for PAP on his $4.00 citalopram script so he didn’t have to go wait in line at Wal Mart for it. *jaw hits floor*

Had this one again yesterday, I’m sure you’ve had it also –
me – “you insurance won’t pay for your refill yet, it’s too soon”
her – “I know, but I threw them out”
me – “I understand, but they won’t pay for it”
her – “Well, how much would it cost me if I paid cash?”
me – “$14.95”
her – “why? it was only $5 last time!”
me – ” . . . “

Thank you…thank you…thank you…this is the #1 thing that drives me crazy. It’s not just the $3.10 patients who whine that it should be less or the surprised gasps of disbelief that the copay has gone up and the last time you even purchased the medication was 2008…it’s the ones that walk up, tell me that they want to know the co-pay for…let’s say Lexapro…don’t know the strength, don’t know the dosage…but they have Anthem!!

Does your pharmacy have a way to check insurance co-pays before transmitting a claim? Mine doesn’t…and as far as I know, there’s not a snowball’s chance in hell that I can guess the price of a lexapro script for an unknown strength and number when there are like…250 differant Anthem plans.

This just proves that no one reads the information from their insurance company…and it really fries my head when they give me a dumb look and go “well…I have insurance, you should just look up my price” ???

Prime example of dumb fucks who have no clue how this works is the patient that walked up to me the other day and handed me a prescription for some random cream. The sig was once weekly…and he demanded that I submit it to his insurance for once a week, twice a week, once a day, and once a month so that he could “choose” which directions made it cheaper through insurance. I told him that under no circumstances was I allowed to commit insurance fraud and change the doctor’s directions to suit his needs.

The most disheartening co-pay encounter I ever had was the day the physician spazzed out at my counter because his copay for a NF drug was $30.00. He literally threw the bag on the counter then stormed out. It blows my mind that physicians have no problem writing for brand name drugs for their fixed income patients, but they themselves refuse to pay those same copays. All in all, I would rather explain things to a medicaid momma than an pompous educated a-hole who should know better.

Ha! Today I had a MD call and scream at me that I was ripping his patient off because he wrote an RX for Xalatan #1, 1 drop in both eyes nightly. He complained the patient had to pay “$65 bucks for this tiny little bottle, which was completely rediculous, and to boot, I gave her this sample bottle of Timolol too!” I explained to him that because he wrote #1 our state law required us to give the smallest size. He continued to aruge with me that I should be putting the customer and their finances first and not try to take advantage of them. He preceded to tell me that I should run “test claims” to tell him the cheapest way to write the med…I preceded to tell him that he should research the laws and learn the RIGHT WAY to fill out the RX instead of telling the patient i screwed up…at least she was cool with it…UGH as if I didn’t have enough to do…sure Its five pm on a Friday night, I have no problem running 15 test claims and calling the insurance for you….ASSHOLE.

Reason number 1 why I will not be working retail post Graduation. There is no amount of money that could make me deal with this day in and day out. I would go “Falling Down” on them within the first hour. Nuke Pharm here I come!!!

I derive some comfort in knowing that complaints about copays, prior auths, and formularies (none of which most customers understand) are universal. A common misunderstanding is the infamous donut hole. Most folks think that it is determined only by their out of pocket cost ie what they pay at the out window. The formula is more complicated than that and is explained on several websites. Our company’s software does print the amount paid by the insurance company but that info does not always satisfy a customer whose copay changed in 2007! We do not receive a message in the adjudication screen about the deductible (which the patient thinks we also set at our whim). If we send a PA request to the MD, we are usually not informed about its approval nor are we responsible if it is denied. We do not have a pharmacy employee whose payroll hours are dedicated only to resolving third party issues….

How about those wonderful \loyalty\ cards from drug manufacturers? They are often presented at pick so the cashier must stop the line and return the rx to the typist. The patient does not know to activate them. We usually discover that after transmitting the claim or a making a phone call to their help desk which closes at 5P Eastern. Then we find out that the COB billing does not apply if the primary insurance does not cover the med!

And then, of course, there is IPledge.

I want to know which other health professionals do so much about insurance problems. Tell us if any doctor, dentist, or therapist spends as much time as the pharmacy staff in calling a help desk in order to answer questions about a patient’s policy while the patient is waiting!

And we do all this in between doing the cycle counts. RTS, and PCI phone calls. And the small matter of getting the right drug to the right patient by \just slapping a label on a box\!

I’m not sure I could handle working at a large chain. I’d probably go nuts. Luckily I’ve only ever worked for one independently owned pharmacy in North Dakota.

Not to say we don’t have the same out-of-this-world issues.

It’s like pharmacy staff is expected to just ‘give me my medication that my doctor said i have to have’. Right. You have to have Latisse. I can see your eyelashes from here. You obviously want it for cosmetic reasons. And no your policy doesn’t cover this product. Yes it’s over $100. Beauty is pain.

Just wanted to say I love your blog! I’m currently studying for my BS in organic chemistry and was considering pharmacy school after graduation, and decided to work as a tech at a CVS for awhile to learn more about the job. Everything you state here I’ve experienced time and time again, it’s good to know that everyone in the pharmacy world has to deal with the same bullshit all day.

I would say try to be understanding that many seniors do not understand health insurance and that when they are paying co-pays, they are not paying the full amount of the medications. Also when someone on a fixed income is cautious of the any money that they pay out of their poackets.

That’s bullshit. They all know exactly what time and what channel their favorite shows are on, which restaurants have senior specials and what time the mail comes. If they can figure out these things, they can figure out their copays. Half the time they are looking for someone to say “ok, we’ll give it to you for this, because we feel bad…” As far as I’m concerned, they are the reason that my insurance premiums are so high. They get meds refilled because the doctor gave them refills (not because they need it), they come in with ER scripts for tylenol and robitussin. If they can’t figure out their fucking copays, they deserve to die. I know that sounds harsh, but I’m more than willing to sacrifice a few old retards to keep my premiums down.

As far as the fixed income goes… I say bullshit to that too. They always have money for smokes and other shit that they don’t mind paying for.

I have to say I agree with Jeff. My pharmacy is across from a hospital, and nothing is more irritating than having a patient say, Uhh I ain’t got money to pay for that…I’m going up front to get a pack of ciggs, then next door to Mcdonalds, I’ll be back in ten for it, k?”

YEP…FUCKING AWESOME. The best part…I WORK in a pharmacy, and I still have to pay my copays!

late reply, but totally agree with Jeff on this one. I have no patience for someone who bitches and complains (usually the “seniors”) about how they have NEVER paid X amount for that script…and after I take the time to look it up and explain that for the last 2 years it’s been the same copay, they smile, nod and say “that’s what I thought”

Fixed income is some shit too, because 9 times out of 10 they are begging me to ring up fashion magazines, cake, beer, etc. etc. and then bitching about a 2.40 copay…they know exactly how much they ‘expect’ to pay, so don’t give me the shit about not understanding copays. Also, I still stand by that after a short, brief explanation of standard copay terminology, it is not my job to stand at the register and take out the leaflets for all 9 of their scripts to show them just how the insurance breaks down on each. How many other patients could I have helped in that time when I know for sure they could have gone home and done it themselves?

News flash Social worker. WE ALL ARE ON FIXED INCOMES!!! My employer doesn’t throw me an extra couple of thousand dollars here and there. Wake up!! Most of these people could get a part-time job to cover their copays. They just DON”T WANT TO, because they are retired. Thats B.S.

To Maine Pharm: Just because someone walks in with a fast food cup doesn’t mean they paid for it. Someone may have given them a gift card. Or they could’ve gotten a free water. I know, free water cups are usually small, but where I live it’s very hot, and if it gets ultra hot and I ask for some water, sometimes they will give me the regular large cups. Also, I have known of people on Medicaid (usually some homeless ones), who grab a used cup out of the trash and fill it with water (and sometimes steal soda as well). Things are not always as they appear. Maybe they paid for the soda and maybe they didn’t.

So I came across this website and love love love it. Currently I’m an intern but this copay thing is just crazy…favorite scenario that happens every month
Gastric bypass paid for by state medicaid pt(gbpsmp): I need my depression drug refilled
me: which one (you have like 5)
gbpsmp: the expensive one
me: all of them are expensive
gbpsmp: well I just don’t know about medicaid they won’t pay for some and than my dr wants me to control my depression because I lost all this weight…
me: which one would you like to refill
gbpsmp: cymbalta thats the one I want cymbalta
me: it requires a PA
gbpsmp: well what else do i have medicaid won’t pay for anything
me: (it paid for your damn bypass) sorry about that we can call the dr tomorrow
gbpsmp: is my klonopin ready to refill
me: no
gbpsmp: thats ok i’ll pay for it
me: $34.99?
gbpsmp: yeah no problem I;ll be back in 5 minutes hurry up cause I gotta go pick up my kid in 10 minutes
me: (as I die a little and go take a 15 minute break) yes we will have you all set (fake smile)

really…talk about health care reform…medicaid has to be reformed first; don’t u think so…I feel your pain. Grandma has a heart condition and donut hole is a big problem but we are thankful that we can afford the medicine and take care of her…

Rethinking Pharm School? Before deciding to enter any Health Professional program, I STRONGLY recommend doing the math showing the true cost of that education. Example: average CA PharmD program >$40K/yr x4yrs in addition to cost-of-living expenses ~$20K (low estimation) brings estimated loan total ~$200K payable over 10yrs (do not stretch loan over 25yrs unless you want to die still having a student loan) or ~$2000/mo (assuming ~5% APR). CA chain pharmacist pay ~$130K/yr (~$65/hr) less ~50% taxes (based on single w/o any deductions) less your student loan ~$2K leaves ~$3K/mo…sorry no house (ave CA home price >$300K) for you for the next 10yrs minimum. I LUV MY YOB!

Watch your GERD, it’s not worth it! Pharmacy sucks, we all know it, so just get the paycheck, laugh with the coworker you actually like and call it a day. The powers that be have ruined the profession so let’s call a spade a spade and just go along with it. Remember, retirement, retirement, retirement.

I have to say this is brilliant. Kudos to you!!!!! I’ve been in retail for 19 years and did my time with the big chains. There wasn’t a day that went by that I didn’t hear some kind of complaint about insurance. Why do I have to waste my time and explain YOUR insurance to you? I understand how MY insurance works because I read about my plan.
I am now with a small independent for the past 6 months and have not had a single arguement about co-pays. I am no longer abused by customers as I was when I was with the chains. I am a pharmacist here and actually talk to patients and counsel them. When I was with the chains I felt more like a secretary than a pharmacist.
Again I give you kudos for actually saying what so many of us think. It should be published and then maybe the public would get an idea of what we go through. A blanket statement would not hurt any one person but strengthen our resolve as a whole on how we are treated.

Good call, PharmIntern… if you read between the lines of many posts, I think you will find many clues leading you to the same conclusion…
At least, we never have a dull moment and will probably never cease to be amazed at the endless opportunities there are to be micromanaged….
Happy holidays to you and yours.

My neighbor and his wife are on Medicare. They live on $694.00 per month and both have health problems which require lots of meds. Their copays are small but those $3.10 charges add up quickly for them. They do not go to dinner. They eat at home with one light on in the house. They don’t buy McD’s coffee. They brew one pot a day so the grounds last a month. They feel guilty accepting the help with their medical needs even though they spent their working lives paying into Social Security.
When they are pushed to desperation by their copays and they comment to their Pharmacist I hope they get better treatment than I see here. They deserve a moment of kindness and commiseration.

Max Drive, have you bothered to actually read any of the above posts??? No one is talking about the scenario you’ve just described. Btw, do your neighbors make it a habit to fill you in on all the details of their daily lives,health, cost of meds, and their finances? Mine don’t.

Actually, I have read all of the above posts. Perhaps you might read Social Worker’s post and the replies attached to it. It is a pretty good example of why I felt the need to post.

Yes, many of my neighbors like and trust us enough to discuss their lives with us. My wife and I are on Social Security so they feel that we can relate. We are also quite good at keeping private conversations private.

Going back to the focus of this post — a $3.10 copay for a medication that costs hundred$ of dollars is a steal, period. It *amazes* me how many people bitch about their Januvia costing them $3.10 when the price of it is really in the hundreds. Would you rather pay your $3.10 copay a month or $200 a month?

I had a customer a month ago who complained that they couldn’t afford their $3 copay for lamictal (The rest of us, or the government, was covering $900 of it). Then how on earth did you get to the pharmacy or doctor’s office, or call me to tell me you couldn’t afford it? You should learn to have your doctor’s write scripts for cheaper medications that will have no copay or get better insurance.

Yeah because studies show that doctors are really excellent about listening to the elderly,let alone the poor, let alone women.

No compassion here, and I have read all the posts. How is someone supposed to “purcahse” their insurance? What world do ou live in where there is a reasonable choice, with apples to apples comparisions, and no sudden changes when the notice comes after the change has been made? Or that is doesn’t happen that getting a 2% increase on your SS and all your insurance etc goes up by 10%

100 years ago, these meds didn’t exist, and people either died or suffered. There is no entitlement to modern technology. Yes, sometimes people struggle. Yes, many times the discrepancies between levels of coverage doesn’t seem fair.

But none of this is the pharmacist’s doing. And the Pharmacist isn’t complaining about the meek elderly who eek out a living and humble themselves to accept government help.

He’s talking about the woman on welfare with 5 kids who don’t have shoes, but mom has plenty of money for an iPhone and to get her nails and toes done once per week, and drive fully loaded lexus. THIS should piss everyone off. The sense of entitlement from those who work harder to maneurver through the system than the’d have to in order to get a job and pay their own way. THIS is what’s wrong with the current system.

FOUR percent private insurance. These are the people who have to pay co-pay, coinsurance, deductible, premium… the litany of labryinthinal (yes I just made that up) terms the insurance industry regenerates annually in order to stupify their consumers. Low income patients compromise FOUR TIMES the medical resources that private insurance does. FOUR TIMES??? Why is this??

I am 26 years old and have had 2 open-heart surgeries…because of my medical bills, my husband and I live on paycheck to paycheck at the moment. With rent, bills, student loans, etc. etc., we do do not eat out, we do not spend more on groceries then we need to, we donate to Goodwill and sell what else we can at yard sales.

So I am pretty much living like your neighbors and i’m only 26, i have not “worked my entire life” for social security, but does that make me a bad person when someone complains that do not have $2.40 for their Singulair and I pay $45 a month to get mine so I can breathe?

You mention that when they are pushed to desperation and comment to the pharmacist…I was wondering just what reply you are looking for the pharmacist to give? In society today, if you commiserate with them, then chances are they always have it worse then you…if you say you’re sorry, it’s awkward because honestly…what can we do to fix it? I always feel weird because when I say I know how they feel, I get fixed with a death glare and a look and a nose in the air…followed by, “you can’t possibly know how I feel”. I don’t understand what the pharmacy is supposed to do to make it better when it’s their insurance that is their problem in the first place?

We aren’t saying that people like your neighbors are idiots…we are simply saying that getting it thrown in your face day after day, time after time, it gets old…and it’s the same patients every month who say the same things. Your neighbors are not horrible people, the elderly man who told me that I ‘faked’ my open-heart surgery scar to get pity out of him and then chose to purchase his cheesecake instead of his blood pressure medicine? He’s the kind of people we’re talking about.

Social Security is not designed to be a person’s sole source of income. It was designed to be a supplement to what a person saved for retirement on their own after working for 40-50 years. If someone worked their whole life and didn’t save anything, or have any investments (i.e. a house that’s been paid for since 1970 that you could sell for 20 times what you bought it for, even in today’s market) too fucking bad. As far as watching what they spend their money on… I don’t buy it. If they worked their whole lives and don’t have anything to show for it except a $694 goverment hand-out, they don’t do a very good job managing their finances. I’ll bet they have cable TV so they can watch their JAG reruns.

Not only that, I agree with Just as angry tech…IT IS APPAULING to see that people abuse the system, get whatever the hell they want for free, including OTC meds, diapers, etc…but can still afford alcohol, cigarettes and drive better cars than many of us…one day at work we counted every patient who waived their copayment thru the drivethru..1 had a lexus, the next was a mercedes, 2 bmw’s AND A LINCOLN NAVIGATOR complete with navigation and wood trim…I think it’s pitiful the elderly who served in our wars and worked hard for a living get stuck in donut holes while 30-somethings feel they don’t have to work because big fat uncle sam will continue to take care of it. Spend a day in the pharmacy and see how we get treated like shit all day, and youd quickly change your mind.

Hi guys! This has nothing to do with the copay topic, but I’m not sure where else to ask this question…

I’ve been a fan of the blog for a long time:) And because of this blog, I desperately want to do something more for my pharmacist and his staff for the holidays this year. I am on a lot of meds, and he is always very kind and helpful toward me. I don’t have a lot of extra cash, but are home-baked goods acceptable? Not to toot my own horn, but I am a decent baker (toot), so would it be totally strange if I showed up with some cookies or something?

I just wanted to ask first, so I’m not just some random patient showing up with cookies.

I would say it is ok to bring cookies. I am a pharmacist and would accept baked goods from several of my patients. And I also have many patients that I would not go near baked goods from their hands! So I guess it depends on the relationship that you have with your pharmacy staff!

I would just ask your pharmacist. I wouldn’t take anything from a customer if it wasn’t wrapped or store-bought. Gift cards to the store they work in is nice so they can buy their energy drinks to get through the shift.

I have to say, as an RPH I would be thrilled to receive any form of thanks from my patients, even a card for the holidays. Most days people are unbearable, especially because they are sick, upset, frustrated after waiting 3 hours in an MD office, not to mention the holidays suck the life out of everyone. We do our best and many patient’s do not realize what goes in to filling an rx. WE DO SO MUCH MORE THAN PUT PILLS IN A BOTTLE….we make sure they are safe, doses are accurate, that your rx’s are billed to your insurances…it’s not easy..all while answering hundreds of phone calls, fielding hundreds of questions, and while many patients love to remind us how we aren’t doctors (although now many of us are) we know so much more than many physcians about medications and many days are making phone calls to correct their mistakes…and very rarely do people take the time to thank us. I am sure your pharmacist would be very grateful for anything you chose to do…baking included. Sometimes a heartfelt Thank you is more than enough. Thanks for the support Tampson!

I don’t know about other stores, but at mine, we LOVE gifts like that from our customers. It might be a little strange if you’re a random customer, but if the staff knows you as a regular, then it shouldn’t be weird. We deal with a lot of grumpy people during the year, so it’s nice to know when we’re appreciated. Puts us in a good mood. If you’re concerned, you could always ask if they have a policy about that. I had a customer ask me if it was okay before he brought us in a plate of Subway sandwiches. It’s nice of you to want to do that.

I think it’s crazy that you’d have to ASK! I work at an independent pharmacy in North Dakota. During the holidays, we get so many goodies from our patients that everyone gains 10 pounds. Home made breads, cookies, cakes, pies, meat platters, you name it. AND we love it. We thanks them by sending out hand written thank you cards. We also get Christmas cards that fill up one of our walls. I love that I know the majority of the people I fill prescriptions for..knowing how their kids are doing, if they bought a new home.. whatever it is. (some days it’s annoying.. but come on..) It’s what makes my job enjoyable most days.

Has anyone seen the commercial about the guy at the hotel who is starting to bitch about his room and the guy behind the counter pulls out a violin and starts playing it for the asshole complainer? THAT WOULD BE SOOOOOO AWESOME TO DO IN THE PHARMACY!!
Sometimes you just want to tell the tech helping the woman with the copay problem to tell her that if she doesn’t like her copay here she can just take her rx to another pharmacy and pay the same copay.
I HATE THE PUBLIC!!

The one that really pisses me off about copay complaints is the cocksucker that sees his %50 copay for a NF drug, then pulls out his card which says $10 for generic and $30 for name brand, and says “these are supposed to be my copays, you’ve made a mistake, re-run it”

At this point I go back the computer, act like I’m actually re-running it, then look at him and say “it’s still $50.” All I need now is some popcorn and enjoy the show that ensues. Watching a grown-up (by age anyway) act like a child is always good for a laugh

When the tantrum is finally over, I really have to bite my tongue so as not to say, “Next time for sign up for an insurance plan, read the fucking fine print.”

The complaints that I hate the most about copays are when some cocksucker sees a $50 copay, then pulls out his insurance card and shows me the generic $10 and brand $30 numbers. Then he proceeds to tell me I’m full of shit and need to re-run it correctly.

At this point I usually go back to my computer and act like I’m re-running it, then look at him and say “it’s still $50.” All I need now is some popcorn to enjoy the show that ensues. It’s always entertaining to watch a grown-up (sort of) act like a child.

I have to bite my tongue every time so as not to say “read the fucking fine print on your insurance plan next time.”

As a young, newly minted pharmacist, I try to see the good in everyone and did my best to answer their questions about their co-pays. If they asked why their co-pays went up, I’d call the insurance company, ask about their plan, and why their copays increased. After spending 15 minutes to a hour on the phone, I’d kindly explain to the patient what I was told and what resources they had. Needless to say, that lasted for about 2 weeks, at which point I could give a rat’s behind. Read the papers that came with your insurance plan, learn about what’s covered and what’s not, and if updates come in the mail, READ THEM. I have to tell my techs don’t prolong an argument with the patient about their copays because it’s not their job, especially if everything is billed correctly. I don’t have time to argue for 15 minutes about their insurance. I basically tell them that’s their copay, do you want the medication or not? I also love it when they tell me I overcharge them *rolls eyes* because yesterday they weren’t covered, but today they are. Sorry, you’re charged based on your current coverage. Not covered? Pay cash or discount price. Covered? Pay your copay. Chains seem to pressure us to appease the customer (whatever, they’re patients) at any cost, but there’s a line between common sense and stupidity. I choose to stay on the side of common sense and give stupidity over to the store manager, my supervisor, and my district manager. At least that way they can get a $25 gift card which STILL wont’ lower their copay :).

Yes, Tampson….we love those baked goods! We were treated to some yummy pumpkin cookies today…..a kind gesture really makes up for the days when we feel “beaten up”. You might want to call the chain’s 800 number or go to their website and let the higher ups know that you are happy with the service, etc. If your pharmacist is an independent, write a letter to the editor of your local paper (mail or online). Or just drop off a note or a card. We appreciate being appreciated!

Wow, after ten minutes of laughing and crying at the same time, I have to say I Love this blog… I completely get your point, actually, I think your point is the point. Its funny how it comes down to bargaining a bargain at the Pharmacy, a HEALTH care provider, I might ad, and being proud of it while walking away in 300$ jeans and hopping into a 75000.00 car, I wonder if relentless bitching can get me 90% off a new Porsche… Although I do believe in getting a break and I do believe in health-care and medicaid, I don’t believe that OUR HEALTH is something to bargain… wait before you start shooting, yes you are entitled to your share of benefits but when your health and well being is worth 30 cents day while your car and lifestyle is worth 100$ a day,
I begin to wonder how proud I am of humanity and how useful it is to look better than we feel.
Now about that new Porsche…

$127 a month? That’s how much I pay for only one of mine . . .
I’m right with you on the blowjob thing, though. I make a decent living, and most of it goes to medications just so I can function enough to GO to work.

I am an RPH and for some strange reason, people thought last week was “free clinic day” at the pharmacy. I had four customers back to back come up to the counter with no insurance, let me fill the rx then say, “well, I dont have money to pay for it.” I just spent 20 minutes filling your ten rx’s and u have no money?! Not to mention one person waited in the pharmacy area for an hour and a half for his “ride” to bring money, all the while watching me lock the place up and go home, and I get there in the morning and hes the FIRST PERSON ON line…I go to ring him up…his response…”well I still dont have the money.” WELL THEN YOU STILL DON’T GET THE MEDS! ugh!

This isn’t about prescription copays, but it’s a frustrating story nonetheless.

One of the families that has been coming to our pharmacy for years has a daughter with severe epilepsy. She is on nearly every medication to treat it, including diazepam to help her remain calm, thus preventing a seizure from coming on.

A few years ago, the child’s mother called in a refill for diazepam at the last possible moment. It turns out she didn’t have any more refills so we called and left a message with the Doctor’s office for a refill authorization. Said mother comes in later that evening to pick up the diazepam and is appalled when she finds the Doctor has still not authorized it. She demands that we loan her some pills until the Doctor gets back with us.

Now, my Pharmacy Manager is a by-the-book kinda gal when it comes to controls. She will not loan them, she will not fill them early, and she doesn’t sympathize with those who ask for any of the above. She told the mother that she would page the Doctor so that it could be authorized asap. Doctor was paged, refill was authorized, BUT the Doctor’s office CHARGED the patient a $25 copay for the inconvenience.

The mother was outraged at us and complained, which got the store manager’s feathers ruffled and he gave her a $25 giftcard to appease her. Talk about ridiculous. This woman knows how dependent her daughter is on meds and continues to be irresponsible concerning timely refill requests. And then it’s OUR fault because we don’t loan on controls and her Doctor will charge her if he needs to be paged. So damn sad.

That’s terrible…goes right along with rx’s dated over a month ago and all of a sudden it’s an emergency to get it filled right now and they will wait because THEY DONT FEEL GOOD….as if everyone else there does…By the way, why would you wait a month to fill an antibiotic?! U were obviously sick enough to go to the MD but not sick enough to fill the RX?! My fiance has a sign up in his pharmacy… “A lack of planning on your part does not constitute an emergency on mine.” Get a clue!

WOW! You really are angry! LOVE this post. People ask me all the time if their ER visit is free. Fuck no, it isn’t free – I mean it’s probably free for you (because you will ignore the bill) but I’ll be covering the expense for you, no problem.

I totally get it, it is SO not the job of a pharmacist to assist their patients in managing their health concerns, a part of which is understanding the financial aspect. It is unbelievable that someone who is sick would have unstable emotions possibly making them yell at you. Sick people never yell, every patient with a raging case of UTI I see in the ED should be nothing but happy and grateful. You just stand behind your counter on your pedestal, count your pills, and look up your shit on Epocrates.

MollyO, the problem is not that we don’t sympathize with our patients, the problem is that when they don’t like their copays, they look to the pharmacy staff as being responsible for “fixing” it. They don’t understand that we have no control over their prices, that they are transmitted online to us directly from their insurance company once the script is processed. The distrust and disrespect that we receive from our patients over copays and insurance is disheartening and frustrating for us to deal with day to day. If only they would understand that their beef is not with us, but with their insurance company, and that we are just trying to fill their prescriptions properly and in a timely manner, the pharmacy would be a lot less stressful for both parties.

So, Molly…it seems you don’t see pharmacists as part of your patient care team, now do you? Oh, well. I have a great relationship with my ED nurses and I hope they don’t think all I do is look up crap on my PDA all day.

Molly must be a stuck up ER doc or nurse (even worse) that thinks they know everything. I guess she doesn’t like the fact that most pharmacists know more than the doctors. The sooner she comes to terms with this reality, the better for her. It is NOT the pharmacists responsibility to know about someone’s insurance. Do you realize how many different plans there are?! To think that a pharmacist should know about all of them and take the time to explain that to the patients is absurd. Patients need to take some responsibility for their own healthcare and stop expecting everyone to do it for them.

Molly O feels that way because she has a billing department in the hospital. I imagine if Molly O had the patient whining and pissing about how much each aspect of their ER visit cost as she was trying to work, she would feel differently. Since she works in a totally different practice environment, which is largely devoid of front line insurance issues, she should just STFU and buzz off.

We have a habitual customer whose kids qualify for medicaid, but still have an active insurance card in his profile. So, I inputted his medicine and out popped a $10 copay from BlueCross, which is fine for most people. But no… he insisted we use Medicaid as a COB and run the Rx through both providers — saving him $10.

That is so fucking unethical, especially considering the fact that he drove a brand new Honda and was wearing Ralph Lauren clothes.

(This is the same asshole who buys Ventolin and cigarettes within 10 minutes.)

I just want to say how much I enjoy your site. I think more people should be more aware of THEIR, yes THEIR insurance plan. They need to be responsible for the coverage that they chose. It is not my decision to make a co-pay amount. I do not say hmmmm, I think this person should pay $50 and this other one should pay $1. I bill it your insurance plan and they(not the pharmacy) tells us what to charge you for your portion of the medication. When customers’ have complaints about co-pays I always tell them to call their insurance and they are more than welcome to leave the prescription with us, until they get in contact with them.
Another thing, is that patients’ in general need to be more resposible with their prescriptions. I get yelled at all the time, because your doctor didn’t call in your prescription. I am not sorry, even though I usually say it,because it is not my responisibility to make sure you are getting your medications, that is your responsibility. And I can not help it if the doctor does not get back to us. If you contacted the docotor yourself, then it would probably be a faster process, for you, the patient.

How about the Medicaid patients who can’t pay their $1 copay & you can’t require that they do??????? I had a patient who couldn’t pay for her Rx’s until the “15th when her husband’s check comes in” & wanted to know what time we closed-she was on her way to the casino & wasn’t sure she’d make it back by closing time…
Although, we do have a very special lady (on a fixed income) who often brings us the most lucious delicious warm chocolate chip cookies you could ever eat! THIS is why I still love retail. God Bless the local corner drug store:)

I really think anybody who has a problem with this post should:
A. not be reading a pharmacy blog because you honestly have no idea what my day to day existence is like. The people who consistently complain about the cost of copays when they have Medicaid or MPD plans honestly help give me hemorrhoids. While finishing my PharmD I was kicked of my parents insurance & had to find some way to cough up the $450/mth to cover my health insurance premiums. Talk about a fixed income, school was too demanding for me to hold anything but PRN work that = maybe 15 hrs per month IF I was lucky. But I did it and didn’t complain about how much my insurance cost because I knew it was a necessity & I budgeted into my student loan money. I wasn’t “poor” enough or didn’t have 3 kids so I didn’t qualify for state funded Medicaid. I was a hard-working 20-something who had to *gasp* pay for things on my own. This is what really gets me. Patients who come up to the pharmacy with a sense of entitlement about having Medicaid. I wouldn’t be proud of it. I absolutely HATE filling rx’s for OTCs under Medicaid. The purpose of this program is not to have everything paid for but to *help* with the cost of health care. I’m sure it wasn’t designed for patients to stay on it for a lifetime.
B. Do NOT tell me that I need to change my career because you come to a pharmacy blog & read that I’m (or any of my fellow pharmacists, retail or otherwise) are aggravated at a patient who cannot do things for themselves. This does not mean that I am not doing my job or giving my patients the care they deserve. Tell me what you do. And chances are it isn’t in health care or any type of public service for that matter. My biggest pet peeve is someone who has NO clue what I do trying to judge me for being truthful. Bad days are bad days. Patients who refuse to take responsibility for themselves are 85% the reason for those bad days. When you are all pissed off because *YOUR* rx isn’t ready on time, I want you to find that patient that I was supposed to waste my time on by babying & doing everything for & yell at them – because after all it wasn’t really my fault for I was being compassionate & understanding.

Homeade cookies have been known to make my day and make me feel appreciated…sometimes it’s hard to feel appreciated in this profession. But please, if you’re a smoker, stick with something that’s not going to reek of smoke when you bring it in.

People just hav no clue what medications cost. And, if you are on some kind of government program like Medicaid then you copay is really low and it is even worse. I remember once when I was helping a customer that was a long time Medicaid customer who suddenly didn’t qualify for medicaid any longer. I told her what all her medicine would now cost her and she replied: “Oh don’t bother, I don’t really need any of those medications. I had no idea they cost that much!” There lies another problem with those programs. People don’t take any responsibility and just get as much as they can out of them without any regard to what it costs everyone else in tax dollars. It is sad really.

Received a call from a lady who wanted us to know that “someone who works there isn’t very smart” Last month her copays came back wrong & she “went ahead & paid what I knew they were.” Well, she was lucky enough to be speaking to the Tech who had filled her Rx’s last month & remembered the situation. The Tech had called the customer’s insurance company after she left (because Mrs. Lovely of course was in a huge hurry) & there was a glitch in their system. This explanation, of course, was more ignorance, & scoffed & belittled my Tech. Anyway, Mrs. Lovely needed her Rx’s filled again yesterday. “Do you still offer free delivery?” She proceeded to tell the Tech where to pull in their driveway, wanted to know exactly when the delivery would arrive, said all she had was a $20 & be sure to bring change. When the delivery gal got there the husband came strolling out from the house clad only in his long underwear! WTF?

If someone whining over a few bucks getting you aggrevated, imagine if they whine over 10 cents. Yes, 10cents! I’m a pharmacist in Australia, and we have quite a different system to you guys, but what we have is a Brand Premium. I’m not sure what it is called there, I’m still getting up to speed with the US system, but if you get the original brand of the med, its a bit more. It can be anywhere between, $0.10 to $10.00, normally its not more than $3.

I still remember being an intern an standing there in the middle of the store (more or less) and having a 70 year old gentleman interrogating me why he needs to pay 10cents for his Zocor brand. The way I was being spoken to was as if I was a criminal, and whatever I said, it would not make a difference his mind was made up, I was a thief.

Not to bore you with rules and regulations, but we need to charge this amount, it’s not an optional thing. After four years of university learning the complexities of pharmacokinetics and studying a double subject of organic and phys chem, you stand there, amoungst the promotional stands for Armani’s latest fragrance being told off for 10cents you have no control over. Even more irrational, is the patient has the choice to not pay it and get a generic, but fears it is just a sugar pill.

The argument that it is the government charge, or in cases of private scripts which are set by the pharmacy owners/company, and out of our control never works. I think the problem is that we are way to nice and stick around and let the customer drone on and try over explain ourselves. Maybe this makes us look more guilty?

Or the patients complaining because the PBS price has risen by 10 cents to $5.40, while they’ve got a pile of crappy $2 makeup sitting on the counter, a packet of cigarettes in their pocket and 600 kids who are currently in the process of destroying the store.

Here’s another…Have a patient who wanted just 2 of her Prevacid that we had waiting for her,because she’s waiting on her coupon to come in the mail. Sure, no problem, it doesn’t cost me anything to print another label & give you an extra vial, not to mention my time… So yesterday, she’s taken the 2 Prevacid, still no coupon in the mail, & wanted another 3 – still waiting for the coupon. Patient says, “I’ve just spent so much money on my remodeling project at home, I just don’t have the money to waste on my medication.” Again, WTF???

Do patients really not know where their prescriptions are? Yesterday a woman called upset that her prior auth could take up to a week. “What prior auth and what drug?” I asked. She replied: : “My friend was just there and was told the medication was not covered.” I checked her profile and she had no med listed since October. “Are you sure you are calling the right place?”, I asked as politely as possible. “Well,” she said, “that is why I stopped coming there. You have too many stores!”

God, I’m so glad I’m no longer in retail. I’ll take dealing with a stupid nurse over a pissed off patient any day. At least the nurses are trying to do something productive with their lives. The douchebags who always bitch about shit like this are so god damn annoying its rediculous. “Wahh wah i have to pay $3.10?” as their Escalade chugs down gallons of gas while they sit in the drivethru rolling on their 20″ rims. Gee, i wonder where you got all that money from, yet youre on Medicaid? Oh, right…here’s your Oxys, Xanax, Vicodin that you need so much. What’s that? You “cant pay” for you childs $5 antibiotics, but you’ll grab your $12-$15 worth of narcs first, and come back in 3 hours magically with enough money? Have a good day scum bag!

100% off topic but I have to vent. Today I called an insurance company to see exactly what a rejection on a script was. It turned out to be that the patient was required to use mail order. I told the person, ok why don’t you guys call up the patient and let them know that. He told me that they would not do that… I had to.

I told him that is bullshit. You are requiring my patient to use another pharmacy. Why in the world would I tell him that. I informed the insurance guy that I was going to lie to the patient and tell them that his insurance no longer covered the drug and that they would have to pay cash price. Under no circumstance would I even mention mail order. The only way for them to prevent this was by calling the patient themselves and telling them they had to get the script mail order.

I of course didn’t actually intend to do any of this. I just wanted to see what the insurance company guy would do. He still refused to call their customer and tell him he had to use mail order. What kind of racket do these people run?

Folks at the third party help desks are just doing their jobs and have zero control over copays. number of fills at retail, etc. Part of the problem is that people do not read the mail that comes from insurance companies because if often looks like junk mail. It really is not the responsibility of the pharmacy staff to keep patients updated on policy changes. We do it as a “courtesy”. My doctor or dentist does not call BX for me. And most medical offices have billing “departments” and do not pay their employees a dollar a minute to resolve TP issues or to ring up makeup and milk! I think we have no one to blame but ourselves. No wonder we feel like whores.

I work at a Walgreens in Louisiana. Medicaid only goes up to 3$ and no tax is added. Further, if someone is on medicaid and says they cannot pay, we have to give them their medication. Not sure if this has changed, but that’s what it used to be. Imagine not being able to pay 3$, and the worst part is when they drive up in a HUGE Cadillac Escalade!! I’m sorry, you can’t pay 3$???

I also just LOVE when we get mistaken for Wal Mart. With their 4$ generics, I get it all the time…”You don’t have 4$ generics??” Uhhhh, no that’s Wal Mart, not Walgreens.

The other night had partialed this lady’s Rx, so she wouldn’t be without and we ordered the rest. I was ringing her up for the rest of the medication and told her the price of 20$ and change. Immediately she said, “Nuh-uh!!! I already paid!!!” I looked things up in her profile (mind you, this was a brand name, no generic drug) and realized that she had paid about 50$ last time. I explained to her that her insurance and divided up the price and she wasn’t paying more (actually she paid about 3$ less that last time), but then she told me that the price was wrong and that she shouldn’t be paying so much, blah, blah, blah. When I preceded to explain insurance tiers and formularies, she just continued to interrupt. What the hell??? She obviously didn’t know a damn thing and when you attempt to educate people, they choose to remain stupid. UGH!!!!!

Nasty people who won’t pay seem to turn up in every kind of public service–and people view health as a public service.

I’m in public transit, and you won’t believe the attitude towards fares. It really ticks me off because when I was poor and relied on buses I always made sure I had a ticket or coins at the beginning of the month and if I didn’t have the fare, I walked.

I know some people can’t walk, but they have ADA cards which let them ride for super cheap or free. I can’t stand these young people who think I ought to give them a ride without paying. You think you’re better than me? You’re not too good to walk, buster.

that’s the problem…the younger generations are just getting worse and worse. they EXPECT for people to do for them and they dont want to work for things…and for that, i blame the parents…or the only one that is in the household! look around at all the people having babies left and right…young having young. what the heck do they know and then that lifestyle just repeats. it’s a shame!

I pay $34 round trip from Chicago to Milwaukee (to visit my husband), even though I am disabled. There is a 15% disount for disabled people. I was surprised to receive any discount. But being handicapped certainly makes things harder for me, not easier.

But I am certainly grateful I have health insurance. I would never blame my pharmacist for a high copay. That’s the craziest thing ever. My insurance company determines how much of each medication they want to cover. My Social Security Income is $694 per month, until I can have one more neuro-orthopedic surgery and hopefully start working, at least part time again. My monthly medication cost of $800 in copays is the least of my concerns. Surgery bills are so much worse. Even with insurance. If you need to see a specialist, and they say he’s out of network, you get stuck paying 20% of a $150,000 brain surgery bill. And this will be my 7th major operation in seven years. That’s more debt than I’ll pay off if I work the rest of my lifetime.

But this surgery will be the one to get me back on my feet again (literally). And without my health insurance, I couldn’t do any of it. It seems unfair sometimes to pay so much. But to stay healthy, or to get healthy, I think it’s worth it.

Had a customer call the other day & say, “I have a prescription for d-y-o-s-i-d-e” I said, “do you mean Dyazide?” “Well, maybe, it’s hard to read this handwriting…does it come in a generic?” “Yes,” I say. “Well, do you carry it?” “Yes,” I say. Then, in his infinite wisdom, he says, “Well, how much will it cost?”
First of all, I’m not sure you’re reading the Rx correctly, secondly, whats the quantity? Thirdly, YOU HAVE INSURANCE NUMBNUTS, how am I supposed to pull a price quote from my tired ass without knowing all the specifics!!!!!
I get so tired of people & their “precious” time. If they have to drop of the Rx & Heaven-forbid, have to wait, you’d think they might just have a coronary before I’m done “just counting & slapping on a label, gosh, how long can that take?????”

Get a clue MollyO. My husband is a pharmacist and gets yelled at all day by morons who don’t understand that he’s not responsible for the price of co-pays. He’s kind and tries to educate the customers but they’re too thick to get it. I wonder how you’d feel getting yelled at all day people. Sick or not, people don’t have the right to treat others so poorly.

I do admit that I have some confusion about my Co-Pays after the 1rst of the year since it is now 40% for non-generics. However, I will figure out whether that is 40% of cash price or the insurance’s negotiated price when I ref ill. I know that magic happens at the pharmacy with my insurance card and a computer and that determines my co-pay and I accept it with a smiling face and a have a nice day after my credit card has run through. I am a patient with brains who has found this wonderful feature of my insurance company’s website where I plug in what med I’m going fill at the pharmacy and what the dosage is and pick which pharmacy I’m picking up at and it spits out for me the cost along with other alternatives with their costs. Hopefully, us smart cookies will outweigh your brainless cash-hungry customers.

Man are you burned out. You should get out of your business and your swearing only shows your ingnorance. I have a very painful medical condition and am made to feel like a criminal when I fill my prescription sometimes. The icing on the cake is that the pharmacist who I see every month for over 3 years suddenly decided to call the doctor everytime I fill. She lied and said it was a new state rule. I know because I emailed the governors office and was put in touch with the chief of consumer affairs for the DOH. I filled my script at the pharmacy accross the street no problem and they had to call to have my pharmacist release the claim in her computer. She told the other pharmacist she had an inspection and had to call the doctors now. The DOH sent me a copy of their inspection report and it was a solid pass. Another lie. I understand a pharmacist has the right to do whatever when they are not comfortable filling a script, but they are not doctors, are they. If you ask me I think that she got a hand slap internally for a reason she is not disclosing. But just like my illness is and treatment is not her business what she got dinged for is not mine. I take my meds as prescribed and for your information, after you take opiates for a month or so you no longer get high, it just helps the pain. I just wish that the body would not become dependent on these meds. It is distressing to have a delay in filling these meds because the doctor has not called back in time. You really need to not lump all your customers into the same group. I know how easy it is to do. I hated it when my fellow car salesmen would make fun of folks with bad credit or boast of the customers stupidity when the just raped them. I was good at my job because I took everything on a case by case basis and refused to take advantage of borderline illiterate customers. You need to get out of your profession or learn to be kinder. Smile and the world smiles with you.

Actually most of us are doctors now for your information…Furthermore, it is our license on the line and I worked very hard for it so if we feel like verifying every single script, that is our perogative. For every one of you, there are 100 addicts who are now addicted because their doctors don’t give a shit…I’m very sorry for your condition but you should be feel even more appreciative to the pharmacy profession that can help you with your pain..

poor, pitiful pharmacist. waw waw waw. get over it or get a new profession. the customers put food on your table, they also look to you for guidance and understanding, it’s called customer service & building rapport with your customer. be grateful in this suffering economy that you are employed.

AND how much does it actually cost to make some medicines? come on! the profit margin is ridiculous! so you and your “stop bitching about your low copays” attitude is not welcomed nor needed.

You can call them whatever you like, but the simple fact is that a customer is someone who exchanges money for a product or service. A patient is someone who receives medical care.

Usually, someone who comes into a pharmacy and fills a script is both a patient and a customer, but not always– consider that a parent filling a script for their child is a customer (they’re paying for it) but not a patient (they’re not the one who will be taking the drug).

Your response is asinine; could you really think of no response better than a flawed attempt at a vocabulary lesson?

Geez,kt,you don’t get it either,do you? WE don’t get any of that “profit margin” it takes to make medications! I (& many others) struggle each week to pay our wholesaler’s bills of thousands of dollars from the mere pittance we receive as dispensing fees. The Insurance companies & PBM’s & the drug manufacturers are the ones who rake in the dough. Not us! Not the ones who enjoy having a good rapport with our customers, who are grateful in this suffering economy to have our customers return for our patience, understanding & time spent counseling, listening & actually caring about our patients. Maybe you’re the one who needs to get a clue, “step down from that high horse” & understand we all need an outlet to vent. You need to be knowledgable about the subject b4 you add your 2 cents.

What gets me is that folks will complain about a 3 dollar charge for something, then hand over a 20 dollar bill when finally pushed to actually pay the fee. All the while asking for 5 dollar marlboro cigs and wearing their brand name clothes and driving their expensive cars.

I simply have one thing that I would like to rant about, okay maybe simply might be the wrong word here. In order for me to get my job working in a pharmacy I had to pass a piss test (I have no problem with this at all). My employer maintains the right to require me to take random piss tests at anytime they see fit. In order for me to “bring home the bacon” they want me to prove that I am not under the influence of any illegal substances, by pissing in a cup.

My wages are then taxed, and part of MY MONEY goes to the worthless pieces of trash that are on welfare. Still with me here….? My point is why in the hell are we NOT requiring these leaches on society to pass a piss test on the 1st and the 15th of every fricking month when they get their checks. I have to be drug free in order for me to bring money in for myself and them, so the least they could do is return the favor. My bet is that if they started requiring piss tests by law in order for them to collect their “paychecks” that some of them if not all of them would get off their asses and become some sort of functioning member of society (even if that meant they had to clean toilets to support their drug habit and their 15 kids).

I know that some of you will not like this idea because the government at the beginning would want to tax us more to cover the costs of giving the UA’s. In the long run I believe that we will have seen a dramatic decrease in the people leaching off of the government (we all know that I really mean you and I here).

Welfare was meant to be an assistance to those in need, not a free fricking free ride for every lazy worthless moron in the United States.

i couldnt agree with you more…..but, i think you should cool it with the name calling! not every person on assistance is worthless trash and a moron!! i hope you never find yourself or a family member in that position. there are people i know who need assitance and they are prideful people and were great parts of the working class before their situations arose.

I guess I should have been a little more clear on my stance here. I do not think that welfare should be eliminated. I know and understand that some people really do need the help, and I am fine with that. I just believe that it should be an assistance. I believe that any one of them that is capable of working should have to, they should not be aloud to just live off the system because the system lets them. My point with requiring them to pass a UA is only to weed out the ones that are capable of working but just choose not to. The ones that are not able to will still get their assistance because they would be able to pass the test. I was just really steamed when I posted the comment because I had some one in the lobby of my pharmacy talking with someone else about wishing that we would hurry up with thier fill so that they could go get high, and then yelled at me because the RX was not free. Telling me how it should be free because they were on welfare and could not afford the $1 copay.

KT, you are clueless as to what retail pharmacy is all about and how the job has gotten worse for us pharmacists over the years. Most of us are paid by the hour. We don’t make a dime off your prescription. We are getting paid to do a job. We don’t like being treated like crap by customers. It is sad that the public is so stupid about healthcare issues. I believe there is a monumental failure in our educational system. I see far too many people that can’t manage their finances and are clueless about how to live their lives without screwing every thing up. We pharmacists have become corporate slaves. Every day we go to work we are beat up by the public and the stupidity of the corporations. We stand on our feet for 10 to 12 hours. We don’t even get breaks! How would you like to stand on your feet all day dealing with rude people and not even get a break? If you think I am just whining, then get you a tech job. All the techs with whom I work hate dealing with customers! So, there must be something WRONG with the job!
And, by the way, YOU don’t belong on this forum. It is a place for pharmacists to vent their anger and frustrations. We have enough problems dealing with the public all day and we don’t need to come here and have to deal with them here too. So….move on…find another blog!

well, i understand being on my feet for 12 hours shifts, but if you dont like your tech job, then find another place to work. unfortunately, in public health, we all have to educate our \patients\ over and over and over again, so understand that. and if you dont have the tollerance for that, dont add more frustration to your life by having kids, cuz it’s the same with them, except you can’t just leave them at the end of the day.

tap waz up u gotta move on to a new topic bud. your fans (me) and your haters (drug addicts) some doctors some pharmacists ken were all waiting to see your newest topic soo lets get wit da program dawg

What gets me is that welfare patients mostly black will complain about a 3 dollar charge for something, then hand over a 20 dollar bill when finally pushed to actually pay the fee. All the while asking for 5 dollar marlboro cigs and wearing their brand name clothes and driving their expensive cars.

I just stumbled upon this site, as someone posted a link on my Facebook feed, and I’ve only read two entries, but from what I can tell, this guy is an awful, awful person. He seems to really hate being a pharmacist, yet he’s decided to spend the majority of his time being a pharmacist. This blog could be called “The Satisfied Teacher” or “The Pleased Bank Teller.” Just find a new career. I personally wouldn’t trust someone who’s this disgruntled to sort and distribute my medication, especially since he lacks the ability to write a sentence without leaning heavily on “fucks” and “shits” and “twats.” This guy’s a joke, and his blog is sad. And now I’m sad. Thanks Angry Pharmacist–jump off a bridge.

i just love it when a customer comes in and they are getting levaquin or tussionex ( now you know how expensive these drugs are ) and i go to ring them up and they say well last time i got it it was $10.00 and i look in there profile and the last time they had it was in feb2008. like are you serious? and then i tell them well you have to call your insurance company and talk to them and they start freaking out over it. like fuck off.

I have about 40 to 50% of our pt’s on medicaid of some sort. But about 75% total are on medicare. I hate to have to take all of a medicare pt’s money. When I say ALL I mean ALL. It kills me to take the entire SSI check from an 85 year old widow. BUT when a 25 year old lazy, monitored drug addict gets all their meds for free EXCEPT their Xanax, Just eats my soul! THe system is most certainly SCREWED UP!!
These people have not ever worked, saw their parents work or had the inkling to work. But will bitch and moan because we tell them it will be an hour and it will take that long before you can go home to sit on your ass and watch Maury. SO SORRY. ANd you can call your customer and tell them that it will take an hour before the Lortab is ready for you to sell to them and then they want the Xanax bagged alone because they will not have the money till later. DUH! You think we are stupid?
Get a life get a job and life will be fabulous!
(I really do love my job, honestly!)

What most of the non-pharmacy employees that are posting on this particular blog do not seem to understand about pharmacists, doctors, and pretty much any other health care worker is that we do our jobs because we get to actually help about 5-10% of patients and that those 5-10% actually listen to us and appreciate us. The other 90-95% could ruin our entire careers, but we keep trying to help because the 5-10% need and want help with their health concerns. We bitch and complain because 90-95% of people are stupid fucks, but every once and a while we have that one patient that has an “Aha!” moment and understands the advice that we give out and that one appreciative patient makes putting up with the other stupid fucks all worth it. So don’t tell us to get a new job simply because most of the patients are idiots, we love our jobs when the patients listen and follow our instructions in order to benefit their own health.

Wow. First time I have seen someone get an attitude with relation to Enbrel or one of the other anti-tnf’s. I really think you should have given that example a great deal more thought. $3.10 may not be much given the exorbitant cost of enbrel (and remicade and humira) but its also likely, in the case of anti-tnf medications, that those receiving it are very severely affected by whichever autoimmune disease it was prescribed for and, quite likely to be long-term disabled, not able to work and in a great deal of pain and financial hardship.

I note you didn’t pick on one of the other hugely expensive drugs for trendy, well known conditions and diseases. They aren’t such an easy target, I expect.

It isn’t our job to “educate” patients on their insurance co-pays, that is their responsibility. Try reading Peon’s post again…I don’t know anyone that would like to experience that day in and day out. I think your comment about not having kids was lame: I might expect rude, nasty and obnoxious behaviour from kids, I don’t expect it from so-called adults, to other adults, in a business setting.

Dude, glorified cashiers??? Why don’t you go find something better to do than get on OUR website where we can get out some frustration. Like… I dunno… Suck Balls? I’m sure you are at least qualified for that job.

You wouldn’t like me as a cashier. I thank god for my techs and clerks that act as a buffer zone between me and slack-jawed yahoos like yourself, who have no idea what we do, how we do it, and why we put up with it. Oh, and have a nice day……

Hi, commenting from Canada. As I understand it, billing prescriptions is at least somewhat different than it is in the states. In my province, the copay for formulary drugs for people on welfare is $2.00. that’s it! I whole heartedly agree that there are a good chunk of people on welfare that abuse the system. However, there are [still] people who depend on it because it is their only option (severely disabled, etc). It is extremely ignorant to clump these people together. Don’t think that just because you spent $100,000 on your education means that you’ll never *ever* end up in a situation where you might need to utilize welfare.

My point is: however frustrating your profession is, if one needs to go to this great length of starting a blog talking about how much they hate “whiney customers”, and to “vent” about their job, they need to get into a new profession. It’s not like you’re working a construction job and you had a shitty day in shitty weather. You’re inside 100% of the time for god’s sake.

I have met pharmacist’s like theangrypharmacist, and they are not plesant people. They couldn’t care less about their patients. As I understand it, the profession of pharmacy serves to provide superior partion care, and one can’t do that if they are miserable. I feel sorry for theangrypharmacist’s patients. Oops, I meant “customers”.

I encounter people all the time who are ignorant and don’t realize that what it is they are getting is much more expensive then they realize. But saying “fuck this” and “fuck that” and other swears doesn’t make you look any better.

Take some lorazepam and move on with your fucking life. I think “1 0.5mg SL tab tid and hs prn” should do it.

or, i have an escalade, 3 kids that wear baby gap, and a coach bag, but i’m going to bitch about my brand name medication that i \have\ to have (even though there are generic therapeutics that work the same way..) being $3.00. is it just me, or do most medicaid patients act like WE owe them something? a lot of the patients i have come in contact with get all pissed off about a 15 minute wait time for 3 rxs.. i mean, really, we’re not fast food or caterers.. YOU have to wait just like everyone else, i don’t care WHO you are.. and i’ve actually heard this a few times.. \I SHOULDN’T HAVE TO WAIT, I HAVE MEDICAID!\ umm.. really..? don’t make me switch your vicodin to a hormone pill..

Max Dome, passerby, Dan St. Clair, Insurance victim, Molly D.,kt and last put not least stupid customer,
Your ignorance is showing. You know NOTHING about what we do. See? This is what we are talking about! Thanks for proving our point, now shut the fuck up.

i guess that no body figured from my post that I actually have been working in pharmacy for these past several years.

this site is about nothing other than a few snooty pharmacists and techs who think that they have it rough. you really think you got it rough? we stand inside all fucking day, the busiest i’ve seen in one day is 821 scripts. it was crazy busy, but my staff and i know that fighting and whining over stupid things won’t make the day go by any faster or smoother.

i love my profession, and i hold it in high regard. no body needs you people transforming this profession in to one of fighting.

i don’t fight with my patients, or doctors, or drug plans.

like i said, we really don’t have it that bad. things could be a hell of a lot worse.

haha!!! waddaya know? my captcha is “reducing service”. souldn’t have said it better myself: that’s exactly what you do.

I would have to agree with you in that those who work in pharmacy are indeed lucky. It’s a secure job in a safe environment (unless one of your patients chucks a bottle of pills at your head, which has happened) that holds great potential to help a lot of people.

However, because you work in Canada, a country whose health care system is nowhere near as broken and screwed up as ours, I’m sure you have absolutely no idea what kind of uproar arises from insurance issues. Do you have patients screaming at you asking why their medication is so expensive because they couldn’t be bothered to check their insurance policy where the cost is clearly explained? Have you gone out of your way to help someone sort out a prior authorization only to have them throw it back in your face?

I’ve lived abroad and I can tell you that people from other countries are a lot more responsible about their health and have much more respect for their healthcare professionals.

The reason the Angry Pharmacist and everyone on this blog are so upset is not because our days are so busy or somebody once expressed dissatisfaction. It’s because a large number of people in this country have a RIDICULOUS sense of entitlement. They think that if they make a big enough scene they can have whatever they want. Unfortunately our “the customer is always right” philosophy (or rather that of the store manager) usually allows them to get away with it. The manager makes the exception and we suffer the consequences.

So you see, I’m sure that anyone here would be willing to help any patient who genuinely needed it. We’re not talking about the simple “whiny” ones nor are we soliciting pity. However, it’s the bitch who insults you, yells, throws a fit and threatens to sue while banging her Louis Vuitton bag on the counter and shaking her Lexus-key-filled fist at you because Medicaid is now charging her 35 cents for her prescription instead of free like last time is what really rubs me the wrong way. If you were treated like that on a daily basis, would you not put up a fight?

For me, it’s comforting to hear others’ stories to know you’re not alone in this madness. I am a PharmD candidate and I have a pretty good idea of what I’m getting myself in to but I wouldn’t trade it for anything. I know I’m lucky but I am still a future angry pharmacist because America will never run out of stupid, ignorant, greedy people.

I have to agree with one view. Unlike medical bills pharmacy bills tend not to be verbose.
Eg: Urgent care bill for $135.00. Contracted rate for *popular plan here* is $109.00. Insurance plan pays for 80% and patient is responsible for 20%. Your bill is for $21.80 as insurance has agreed to pay the remainder of the contract rate.

OH NO. Typical pharmacy bill only says “Copay $15.00”. It won’t break down from standard cash rate of maybe AWP -10% + $10 dispensing fee (haw haw haw) to contracted rate to how much the patient’s plan agreed to pay towards that rate. Let’s say AWP -18% + $2.50 and patient is responsible for either a flat copay or a percentage.

The patients with percentage based copays usually get it because they easily feel the drug costs. It’s the uninformed socialized ones that aren’t able to feel the true costs of their drugs and it’s because if a pharmacist revealed their bottom line (the cost formula) then people would know where to get their prescription for the lowest cost with cash (no insurance). Nope. They gotta call 20 pharmacies around town to end up going to Costco to get poor service but get their Rx for 5 bucks less than the mom-and-pop shop down the street.

tl;dr
Pharmacies don’t disclose their overhead because of the cutthroat tactics we all employ…

So, when I happen to be responding to bullshit on some fucker’s blog on my netbook Dell Inspiron mini9 with *incredibly* small shift keys, that instantly makes me not a pharmacist? Whatever you say…

mojome007, seriously, you need to fuck off.
JustAsAngryTech, I lol’d at your comments.

To everyone else, I’m glad I don’t work in the United Fucked-up States of America. You guys are so fucked, you don’t even know it.

Now, I’m going to delete this blog from my memory, and I won’t bother coming back. Most of you are clear examples of people who are sorry they entered a profession that they can’t handle because of a few whiny patients. Grow a pair and suck it up.

I’m interning at a store that does 50%+ Medicaid and I see this type of non-sense all the time. Quite honestly, I think we are in trouble as a society. “$2.20?!?! WHAT? I can’t pay that!” … WHERE DO YOU PEOPLE COME FROM?!? Get off your ass and stop having kids. Enough is enough.

bullshit….you are NOT responsible to cater to the ineptitude and ignorance of someone who does not know their insurance….it is THEIR responsibility, cut and dry……we routinely tell the people if the the drug is expensive, and what the copay is before we fill it or i break the seal on a $500 medication, but to insinuate that I, the pharmacist, have A DUTY to explain their policy to them? there is no way in hell you would do the same, nursing student….wait until you get to the real world, baby…..you haven’t seen shit til you deal with in on a daily basis, the IGNORANCE AND APATHY— the uneducated and illiterate I sort of sympathize with, but your blanket statement is asinine ans presumptuous, and quite naive in you inexperience…..
you WILL learn, mark my words….

No more pulling my hair on this issue.
I just tell them I don’t have control over the copay portion of her or his insurance. if they have any questions,call customer service. If there is any issues with insurance company, we will be glad to rebill and give them refund.

This has happened few times that insurance said the pharmacy was billing wrong
and customer’s copay should been lower,etc.
I told customer if pharmacy billed to wrong insurance then insurance company should reject the claim but they didn’t because they still processed.

“””Yeah, that’s fine, but bitch at some Indian drone at Blue Cross, not me.””””
See, I was totally agreeing with whatever you have been saying this whole time and you just had to FUCK it up. With that stupid comment of yours, you yourself just entered the world of stupid and ignorant people. You rant about how people treat us pharmacists and make assumptions about our jobs. And there you go doing the exact same thing. I thought you were smarter, but it proves that just because one goes and gets a degree, it does not rid them of their ignorance or prejudcies. GOOD JOB BOSS.

Not sure why people are complaining that the pharmacy didn’t notify them when their copays change. 1) We don’t know until after the claim has been sent to the insurance company, so we don’t know at the initial point of med request (when patient calls for refill or drops off rx), what the copay is. 2) Is knowing that your copay changed 1, 2, 5, or x hours ahead of time, before you purchase the medication going to change anything? Perhaps in a small number of cases, a patient may think a certain copay change is “too high” and want their MD to change drugs, but even if such was the case, it often takes MD’s 4 hours, 8 hours, or even days to respond to medication requests (greatly overshadowing the 1, 2, 5 , or x hours stated above). 3) In most of the retail settings I work, I don’t have enough time or ancillary staff to guarantee 100% quality assurance; Why should I reduce the time I spend looking for errors (both internal and prescriber related), drug interactions, and performing other clinical/professional job duties, just so I can spend more time looking to see what a person paid last time, comparing it to this time, then calling then to tell them they will have to pay 15 dollars instead of 10 dollars, or 3.10 dollars instead of 1.10 dollars (because I can’t read minds, I would not know a particular patient’s tolerance for price changes (one person may not mind a 5 dollar increase, while another person may not tolerate the 2.10 increase), thus i would have to call on each and every copay change). Why should more people die or be wounded by missed drug interactions or errors, just so everyone can know that their copay changed a few hours ahead of when their pick up time is? Pharmacy profits are so razor thin that dedicating more resources to secretarial tasks and customer service means having to pull resources from clinical duties.

One welfare recipient’s comment, made 9 years ago, comes to mind. She hadn’t worked for years, but kept on making babies to keep those medicaid checks coming in.

She asked for a refill for her husband/boyfriend’s metoprolol one sunday, adding the phrase, “…and make it snappy”. There was a 0.50 dollar copay for the med. Why should i (being a taxpayer and therefore paying for her life and procreation), be demanded to “make it snappy” for something that is the same price as a telephone call? My blood pressure went through the roof on that one.

Pharmacists will NEVER tell you the actual price of the medication because honestly, it will probably piss you off. Why? Because normally when medications are dispensed, the profit made off of 1 perscription usually covers the cost of the entire bottle. (Depending on the ins of course) Pharmacies have to bill your insurance an outrageous amount because in order to make a (big) profit, they have to charge as much as they can to make as much as they can. Before I started working in a pharmacy I always thought that the price a person would pay without insurnace was the same price the pharmacy was charging the insurance (HA!!!!!!) YEAH RIGHT!!! Without insurance, lets say a person would pay $25. Well….the pharmacy is probably charging your insurance $400 for the same medication. NO WONDER OUR RATES ARE SO HIGH!!! F*CK!!! And dont even get me started on people with Medicaid!! I have no problem with people that actually need the help BUT if you have Medicaid and you are getting into your BMW and driving home, WHAT THE FUCK!!!!! This shit needs to change asap!

OMG! You are a horrible pharmacist! Of course you can’t understand why people can’t afford their copay. You make more money than most and no I am not one of those people you are complaing about. It is not a matter of what they get for the money they just don’t have the money! My suggestion to you is to get into a different line of work since you clearly hate your job!

teri, we would be horrible pharmacists, if we actually SAID these things to our patients. Fortunately, for the patient, we swallow this shit, which feeds our ulcers and blood pressures, so we have our own copays to worry about, too. I make good money, but I busted my ass in pharmacy school, racked up a tidy loan bill, and worked long and hard (hehe….long and hard…..) to work that down. You want to complain about my paycheck? Walk a mile, or, stand for 12 hours, in my shoes, or fallen arches, or bad knees.

may I ask why each person who suggested that the pharmacist explaines the co-pays gets thumbs down? Even tho I already know why I pay 25% of all prescriptions it is always nice to hear the pharmacists offer to explain, excellent pt service
OK now everyone can hit thumbs down now or Angry can delete my like he has done many times before!! Why do you hate me so Angry??? Hell you wrote a blog about my hate mail once lol

It’s the politics of time, Missy. Because YOUR insurance doesn’t pay the pharmacy enough money to do everything everyone wants them to do in the time frame in which they want it done, the staff have to pick and choose tasks that are of the greatest importance from a larger set of possible tasks for a given period of time. When YOU ask to see the pharmacist when you think a copay is “wrong”, your actually taking time out of his/her schedule that would be otherwise used for checking drug interactions, adjudicating all the prescriber errors (yes, prescribers have a embarrassingly high rate of errors, concerning prescribing) and internal errors, screening profiles as a consultant (for example, screening a prostate or breast cancer patients’ profiles to see if they are on a bisphosphonate, because such has been shown to be beneficial for these type of patients; or screening asthma or diabetes patients to recommend an influenza vaccination, etc…), or double checking a physician’s dosing of a child’s medication (especially regarding oral liquid sedatives, which have had a history of fatalities/injuries associated with doing errors). Every time you ask a pharmacist to act as your personal secretary for a task you could actually perform yourself, you detract from their professional duties – duties you cannot perform, but ultimately benefit from. A large portion of a pharmacist’s time is now spent doing secretarial work in the name of large chain “customer service”, at the expense of professional service which would actually be more beneficial to society in terms of reduced clinically significant error and drug interaction rates, reduced cost of healthcare and increased personal health secondary to drug utilization review and efficiency maximization, etc…

I agree, it’s not the pharmacist’s responsibility to explain co-pays. That’s between the patient and insurance company. However, I’ll just point out that insurance companies can be GROSSLY incompetent in providing people with information about their own policy, especially in policy changes. In fact, I’ve been in situations where my co-pay unexpectedly changed, and even the insurance company can’t explain why when I call them later. I talked to multiple reps and they all had different theories, but no answers. This is Anthem Blue Cross of California. Then I went to go on their Web site to try to download my latest policy docs for some other issue, and their site is always having connection and slowness issues. And then the newest policy pdf they have available to download is 3 years old, and I know there have been many changes during that time. I’m sort of stuck with Anthem as long as I work for my current employer. Otherwise, I would pay a bit more to have predictable co-pays when I go to the pharmacist, doctor, etc. Again, I feel bad for the pharmacists, doctors, that have to be the first one to deliver these co-pay-change surprises to people. I do not feel sorry for insurance companies though. I make a living out of confusing people so they don’t use their policy, or scaring them into not getting their meds with an unexpectedly and inexplicably high co-pay snafu.

So well said. I’m a tech an there is absolutely nothing as frutrating as patients bitching about copays, especially the ones who say “I never have to pay, its always free”. Why do these douchebags think that way?

Very well said. Nothing psses mr off more than patients bitching about small copays, especially the idiots who say “I never have to pay”-BS! I once for a formal disciplining for telling a patient that “it’s only $3.00”! We techs have to deal with more of this nonsense than the Pharmacist and it DOES take a toll. This copay crap even bugs me more than my 2nd rant which is not getting off your damn cell phone.

Basiorana,
Not all pharmacies have a program that allows them to give you the price of a med with your insurance without having the actual paper rx. Wal mart must have the actual rx, input it into the system, submit the claim, and THEN can give you the price. The “aide” has no say in the price of your medication, and many pharmacies lack the ability to tell you an exact price. TALK TO YOUR INSURANCE COMPANY. JEEESUSSSSSSSSS. People amaze me

We ( me, husband, 2.5 yr old child) pay around $900 a month for insuarence. I take a drug named singuliar which my copay was $25 until last month. Now the insuarence company want me to pay $40 copay for it, just because I would not tie the cheap junk they want me to take. ( my Dr prescribed Singulair). Insuarence is a waste of money.

WOW THANK YOU FOR YOUR OPINION ABOUT WORKING WITH THE PUBLIC.WHETHER YOU REALIZE IT OR NOT IF IT WASNT FOR THE FUCKING PPLE YOU WOULDNT HAVING A FUCKING JOB. SO STOP BITCHING BITCH AND THANK GOD YOU HAVE A JOB.YES WORKING WITH THE PUBLIC IS DIFFICULT I HAVE BEEN WORKING WITH THEM FOR OVER 30 YRS.BUT YOUR POTTY MOUTH,YOUR ATTITUDE AND YOUR APPRECIATION THAT YOU CAN FEED YOURSELF IS DEFINATELY SOMETHING YOU DO NOT APPRECIATE,IF YOU CANT STAND THE HEAT GET OUT OF THE KITCHEN AND GET A JOB AT THE LIBRARY WHERE YOU CAN BLOCK YOURSELF AWAY.I WOULD LOVE TO SEE YOUR SOCIAL LIFE.GOOD LUCK,GOD BLESS FOR YOU WILL END UP WITH A MASSIVE CORONARY DUE TO YOUR MALICE AND NEGATIVITY.

Some of you pharmacists are full of it , or maybe sampling some of your schedule II’s. Example Meloxicam 30 mg #100 cash price $4.00 but if you have insurance: co-pay $10.00——-WTF!!!! Atarax 50 mg #100 cash price $3:00 but if you have insurance co-pay $10:00 and the list goes on. Maybe pharmacists should consider changing careers, perhaps becoming a lawyer since your current moral and ethical standards are in the same cesspool.

I pay cash now… $400 premiums per month for a doctors appointment every 3 months and $75 copays on each and then hours of horse shit… It was cheaoer retail for the brand and the $125 visits to the doctor paid more than insurance and I saved tons of case… woo hoo!!! more new tattoos to hide under the suit and tie.

Love your article, and I agree with you 100%. However I have a simple question that I have been seeking the answer to- do insurance companies pay retail price minus copay for medication. Or, do they use their buying power to reduce their portion to well below retail? This is for school. Thanks!!

Some actually think if they have to pay $1.10 it’s too much. So if they know they can skip the copay by running up the amount by going into the “catastrophic” category. Thereby beating the copay. Granted, they disgard the pills. But by running t J e bill up they pay ZERO. …

If it was required reading for anyone without insurance, I would rather give up my insurance, and let my health end up however it ends up, and pay the no-insurance penalty than to be forced to read that type of language. As soon as I saw the first instance of that horrible word, I had to stop reading. Then I jumped down to the comments and see this, about required reading. I don’t think so. The day someone “requires” me to read something with all those nasty words in it is the day I stop reading at all. Also, if my profession were causing me this much seeming anger and hatred, I would change my profession, because I know what the health effects of this are. This pharmacist definitely does not appear to be a people person. Of course people will complain. That can happen in any profession. A people person understand this. Sounds like the customers have control of the pharmacist instead of the pharmacist having control of himself.

its all bullshit i am on medicare and my meds are 200—300 a month! and yes its generic!pharmacies are scams now i but it through canada at only 31 dollars a month sure i have to make sure i order a little ahead but well worth it —-don’t blame pharmacies blame big pharma